Organizational Change From Facility-Based to Community-Based Employment Services

1. Organizational ChangeFrom Facility-Based to Community-Based Employment Services Pat Rogan September 13, 2012

2. Why Change from Sheltered to Integrated Employment? • People receiving services dissatisfied • Poor quality sheltered services & outcomes • Knowledge of best practices • Push from external entities

3. How are we Doing? • Integrated employment declined to 20.1% in FY2011 (Butterworth, 2008) • Increased segregation + non-work community activities. • 625,000 in sheltered facilities earning subminimum wages. • The rate of movement from sheltered to integrated work: a mere 1-5%.

4. How are we Doing? • Medicaid spends 4X more money on segregated adult day programs than supported employment. • No preference for integrated employment within the Medicaid program. • Many (if not most) in sheltered day programs prefer to work in a real job in the community. (Migliore et al, 2007)

5. Looking Back… • 1990s: Systems change grants & initiatives supporting organizational change, e.g.,: • Albin, Rhodes, & Mank, 1994 • Murphy & Rogan, 1995 • Rogan, Held & Rinne, 1998 • Butterworth & Fesko, 1998, 1999 • Petty, Brickey, Verstegen & Rutherford, 1999

6. Critical Features of States with Highest Employment Outcomes • Philosophy, policies & funding support integrated employment. • Statewide capacity building & advocacy efforts; systems change initiatives. • Strong, consistent leadership. • Data based decisions.

7. Major Barriers to Change • Negative attitudes & resistance (e.g., staff, families, Board) • Funding (Inflexible, insufficient) • Lack of expertise (re: organizational transformation) • Lack of leadership • Other: Transportation, safety net • NOT: Resistance from people with disabilities or community.

8. Understanding What to Change The Organization

9. . Organizational Change Strategies • Create a Vision for the Future (Strategic Plan) • Mobilize Commitment (Stakeholder Buy-in) • Develop Strong Leadership (Change Management Team) • Align Services, Org Structures, & HR Practices

10. SERVICES: CE Competency Model

11. Effective Employment Strategies Positive Community Services • No need to “get ready” - Teach in community. • Person-centered & directed planning – Capacity search. Traditional Services • Focus on readiness • Move through continuum • Deficit-based voc. evaluation

12. HR:Develop Entrepreneurial Leaders • Teach skill sets (Discovery, Job Development, etc.) alongside leadership abilities. • Widen agency vision to include front-line staff as community builders. • Focus on staff development through active mentoring from supervisor (community-based staff positions cannot be supervised by a building-based manager).

13. In the past a leader was a boss. Today’s leaders must be partners with their people…they no longer can lead solely based on positional power • Ken Blanchard

14. What Maintains a Structure • Hierarchy • Expertise • Specialization • Misunderstanding of mission • Traditions • Fear…it is the hardest change of all!

15. If You Add Specialists: It’s not my job You have to talk to my boss How are we going to pay for it? The result: Incremental change. To Change Your Structure: It’s everyone’s role Build rapport and permission will come Know your stuff Do the right thing and the money will come. The result: Real change. Structure: Think about it…

16. Tips from Those Who Have Been There • Involve all levels in discussion of vision & values. • Invest heavily in training. • Use the vision & inherent values to evaluate processes/outcomes. • Use individual planning for all. • Communicate, communicate, Communicate!

17. If you don’t like change, you’re going to like irrelevance a lot less. • Tom Feltenstein

18. It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to changeAuthor unknown

19. Partnerships – Critical to Success! • It’s all about Relationships! • People served • Families • Staff • Board • Community; Employers • Funders

20. FUNDING • Economic Development & Diversity • Relationships with Funding Sources • Diversify—pros and cons • Business Approach

21. Sustainability • Coalitions start at home. Align leadership with visionary outcomes. • Staff need more than a financial reason to believe in the work. Managers and agency leadership have to be vested through actions. • New skill sets can be taught if they are illustrated rather than only benchmarked.

22. Recommendations…National Level • Develop a national agenda for change • National OC Forums • Employment First Initiatives • Comprehensive Transition Services • Shift funding from sheltered • Support for leaders to learn how to change

23. Recommendations….State Level • State Level Leadership! • Employment First Initiatives • Post-secondary Ed Initiatives • Funding controlled by people with disabilities and families • “Training Arm(s)” in each State

24. Recommendations….Local Level • Share Success Stories • Provide Staff Training and Support • Partner with Self-Advocates • Learn from Success

25. We are far too patient with the passage of time for people with disabilities…time is as precious for a person with a disability as it is for all of us! • Gary Provencal

26. Resources • Rogan, P. & Rinne, S. (2011). National call for organizational change from sheltered to integrated employment. Intellectual and Developmental Disabilities, 49 (4), 248-260. • Butterworth, J. et al (2011). StateData: The national report on employment services and outcomes. ICI – U-Mass, Boston. • http://www.communityinclusion.org/page.php?id=17&page=get_article&scope=all&type=topic